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Board Rule 61b30 Form Wc205request For Authorization Of Treatment Or Testing By Authorized Medical Provider

Authorized medical providers seeking approval for treatment or testing shall send this form by facsimile or e-mail directly to the insurer/self-insurer who must fax or e-mail a response within five business days.  Neither the request nor response shall be filed with the Board, unless otherwise requested.

  • Form WC-205/Request for Authorization of Treatment or Testing by Authorized Medical Provider

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Seth Bader
(678) 562-5595